| NPI | 1427166396 | 
|---|---|
| Former Name | SARA LEAH GILLES | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 3507) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1055) | 
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2025-01-15 |